scholarly journals Digital Health and the State of Interoperable Electronic Health Records (Preprint)

2018 ◽  
Author(s):  
Jessica Germaine Shull

UNSTRUCTURED Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations—a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.

10.2196/12712 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e12712 ◽  
Author(s):  
Jessica Germaine Shull

Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations—a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.


2017 ◽  
pp. 215-241
Author(s):  
Nelson Ravka

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.


2017 ◽  
pp. 543-569
Author(s):  
Nelson Ravka

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.


2019 ◽  
Author(s):  
Louise Amaral

The proposal of this study, with an exploratory and descriptive approach, was to identify the use of Web Tools 2.0 of production, circulation, sharing, storage and access to electronic health records (RES) by the organisms producers of Health care Services (OPSAS) in Bahia. The immersion of OPSAS in cyberspace requires the competencies of health agents to produce, receive, accumulate, access, use and migrate electronic health records (RES) directed to digital repositories. The adoption of the Web 2.0 philosophy allows the expansion of the OPSAS relationship with health agents and stakeholders and extends to the participation of citizens. As a result of this research, from a questionnaire applied in 26 hospitals in the state of Bahia (linked to a network of innovation and learning in hospital management), it was found that OPSAS use the Web Tools 1.0 well more than the Web 2.0. We opted to conduct a direct and systematic observation on the websites of 38 bodies producing health care services, in order to verify the incorporation or not of the devices of the Web 2.0 and the possible advances and/or setbacks on the incorporation of the Web 2.0 Philosophy in the OPSAS.


2017 ◽  
Author(s):  
Jonas Moll ◽  
Hanife Rexhepi ◽  
Åsa Cajander ◽  
Christiane Grünloh ◽  
Isto Huvila ◽  
...  

BACKGROUND Internationally, there is a movement toward providing patients a Web-based access to their electronic health records (EHRs). In Sweden, Region Uppsala was the first to introduce patient-accessible EHRs (PAEHRs) in 2012. By the summer of 2016, 17 of 21 county councils had given citizens Web-based access to their medical information. Studies on the effect of PAEHRs on the work environment of health care professionals have been conducted, but up until now, few extensive studies have been conducted regarding patients’ experiences of using PAEHRs in Sweden or Europe, more generally. OBJECTIVE The objective of our study was to investigate patients’ experiences of accessing their EHRs through the Swedish national patient portal. In this study, we have focused on describing user characteristics, usage, and attitudes toward the system. METHODS A national patient survey was designed, based on previous interview and survey studies with patients and health care professionals. Data were collected during a 5-month period in 2016. The survey was made available through the PAEHR system, called Journalen, in Sweden. The total number of patients that logged in and could access the survey during the study period was 423,141. In addition to descriptive statistics reporting response frequencies on Likert scale questions, Mann-Whitney tests, Kruskal-Wallis tests, and chi-square tests were used to compare answers between different county councils as well as between respondents working in health care and all other respondents. RESULTS Overall, 2587 users completed the survey with a response rate of 0.61% (2587/423,141). Two participants were excluded from the analysis because they had only received care in a county council that did not yet show any information in Journalen. The results showed that 62.97% (1629/2587) of respondents were women and 39.81% (1030/2587) were working or had been working in health care. In addition, 72.08% (1794/2489) of respondents used Journalen about once a month, and the main reason for use was to gain an overview of one’s health status. Furthermore, respondents reported that lab results were the most important information for them to access; 68.41% (1737/2539) of respondents wanted access to new information within a day, and 96.58% (2454/2541) of users reported that they are positive toward Journalen. CONCLUSIONS In this study, respondents provided several important reasons for why they use Journalen and why it is important for them to be able to access information in this way—several related to patient empowerment, involvement, and security. Considering the overall positive attitude, PAEHRs seem to fill important needs for patients.


1970 ◽  
Vol 9 (3) ◽  
pp. 140-147
Author(s):  
B Devkota ◽  
JF Lamia ◽  
N Pommer ◽  
J Smith ◽  
B Whitman

Background: Studies have found that health information technology can improve the quality and efficiency of care delivery through better decision support. Objective: To gauge the effectiveness of electronic health records (EHR) training that was delivered to health care providers in an academic practice, to leverage feedback from the training evaluation to inform the content and process of training health care providers and to understand the impact of EHR implementation on all facets of health care delivery. Methods: A mixed methods instrument was designed to assess learning outcomes (cognitive, attitudinal and behavioral) associated with EHR training. A sample of 220 health care providers who regularly interacted with the EHR system was included. Participants were asked to evaluate cognitive, attitudinal, and behavioral aspects of their training with the EHR system. A multidimensional assessment of learning outcomes was selected. Results: On behavioral theme, 50% of our survey respondents answered the questions positively, 28% did not, 16% had mixed feelings, 3% felt EHR had negative impacts and 3% were neutral. On cognitive theme 31% felt EHR had a positive impact, 33% felt it had drawbacks whereas 35% left the answers blank and 1% felt they had no idea. On attitudinal theme, there was positive response from 45%, 21% had negative feelings about the system, 5% were neutral and the rest 25% did not answer. Conclusions: In this study, we found that majority of the respondents were satisfied with the EHR for behavioral and attitudinal themes. Future studies with mandatory response to cognitive theme will help figure out the satisfaction of survey respondents on all themes. DOI: http://dx.doi.org/10.3126/hren.v9i3.5580   HR 2011; 9(3): 140-147


Author(s):  
Nelson Ravka

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.


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